Topics Related to Medicaid Managed Care

This rate increase in the latest Physician Administered Drug Program fee schedule supports treating Medicaid members for Congenital Syphilis.

An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of Dec. 1, 2023, is posted.

Includes information on LME/MCO consolidation, Innovations and TBI waivers, federal fee increase, updates to NCTracks, Medicaid expansion and more.

Includes rate considerations for Medicaid Expansion members effective Dec. 1, 2023.

CorDx, GoToKnow, FaStep COVID-19 AG Home Tests added to coverage.

NC Medicaid will update the PADP fee schedule effective Feb. 1, 2024.

The updated policy aims to minimize the impact of health plan accreditation on delegated care management entities

North Carolina Medicaid will reimburse pharmacies for utilizing the statewide Self-Administered Hormonal Contraceptive Protocol for pharmacists.

NC Medicaid will begin publishing the POS vaccine rate file in January of 2024